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Experts of the Union of Pediatricians of Russia have developed modern guidelines on management of children with acute respiratory viral infection. The term “acute respiratory viral infection” (ARVI) combines following nosological forms: acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, upper respiration tract infection (unspecified). The issues of epidemiology, diagnosis, treatment, and prevention have been considered in detail.

Experts of The Union of Pediatricians of Russia have developed current clinical guidelines for management of children with community-acquired pneumonia, which were approved by the Scientific and Practice Council of Ministry of Public Health of the Russian Federation in January 2022. Particular attention is paid to the etiological structure, modern classification, diagnostic tests and flagship approaches to antibacterial therapy of community-acquired pneumonia in children based on the principles of evidentiary medicine.

Experts of the Union of Pediatricians of Russia have developed modern guidelines on the management of children with acute obstructive laryngitis and epiglottitis. Croup is the most common cause of acute upper respiratory obstruction in children aged from 6 months to 6 years. Usually respiratory viruses are the pathogenic agents of the disease. The etiological factor of epiglottitis is Haemophilus influenzae type b in the vast majority of cases (> 90%). However, nowadays, epiglottitis caused by this pathogen agent is more common in adults in countries with mass immunization against hemophilic infection. This article considers in detail etiology, pathogenesis, and classification issues. Special attention is given to diagnosis, differential diagnosis, and therapy (via evidence-based approach) of acute obstructive laryngitis in children.

Currently, acute tonsillitis remains the most prevalent pediatric respiratory disease. The disease most often occurs in children up to 4 years of age, and in children of this age it is exclusively a viral disease; the viral tonsillitis contribution in older children is 60-80%. However, despite these figures, survey of physicians and parents, as well as audit indicate that the rate of prescribing antibiotics to children with acute tonsillitis is 90-95%, which means that the majority of children receive unnecessary antibiotic therapy. Appropriate differential diagnosis of the diseases, involv-ing the pharynx and tonsils, is a top priority for practicing otolaryngologists and pediatricians. The paper reports rare clinical cases of parapharyngeal abscess, adenoviral tonsillitis, infectious mononucleosis, PFAPA syndrome.

The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.

The experts of the Union of Pediatricians of Russia have developed up-to-date clinical guidelines on management of children with acute bronchiolitis. Around 150 million cases of bronchiolitis (11 cases per 100 infants) are registered annually, 7–13 % of all cases require hospital treatment and 1–3 % require management in intensive care unit. Almost all children of the age under 2 years old (90 %) undergone respiratory syncytial viral infection. In 20 % of them they have bronchiolitis due to various factors. This article covers the issues of epidemiology, pathogenesis, differential diagnostics, treatment based on the principles of evidence in detail.

The clinical recommendations on management of children with Gitelman syndrome developed by the experts of the Union of pediatricians of Russia are presented in this article. Gitelman syndrome is a dysfunction of distal renal tubules with further development of hypomagnesemia, hypocalciuria and secondary aldosteronism which determine hypokalemia and metabolic alkalosis. Features of epidemiology, etiology and pathogenesis, disease progression, differential diagnostics and evidence-based treatment are presented.

The authors provide a review of current clinical guidelines regarding medical care provided to children with Bartter’s syndrome — impaired renal tubular function (loop of Henle) with the development of hypokalemia, hypochloremia, metabolic alkalosis and hyperreninemic hyperaldosteronism. The specifics of disease epidemiology, etiology and pathogenesis are described. The issues of differential diagnosis and treatment based on the principles of evidence are covered.

The Jarisch-Herxheimer reaction (JHR) is a shock-like state in response to antimicrobial therapy due to the release of toxins from decomposing microbial bodies. The reaction mainly occurs in patients with spirochetosis, less often in patients with brucellosis, bartonellosis, rickettsiosis, and can be possibly observed in patients with sepsis or meningococcemia. The JHR in children with community-acquired pneumonia has not been previously described. The article provides the author’s own observation of a similar reaction in a child with upper lobe pneumonia associated with amoxicillin treatment and resolved after the administration of prednisolone.

Pneumococcal infection remains one of the leading reasons for infant mortality from vaccine-preventable infections. Today vaccination is the most effective way to prevent diseases caused by antibiotic-resistant pneumococci. In the article, authors present current approaches to vaccinal prevention of pneumococcal diseases. The plan of action for carrying out active immunoprophylaxis of pneumococcal infection is explained in detail for both healthy children and patients from risk groups for severe pneumococcal diseases development. The published work is based on key points of the guidelines of the Ministry of Health of the Russian Federation on vaccinal prevention of pneumococcal infection (developed and approved by the professional association of pediatricians «The Union of Pediatricians of Russia»).

The clinical recommendations on management of children with Liddle syndrome which is characterized by severe hypertension along with low activity levels of renin and aldosterone in blood plasma, hypokalemia and metabolic alkalosis, were developed by the experts of the Union of pediatricians of Russia. Aspects of epidemiology, etiology and pathogenesis, disease progression, differential diagnostics and evidence-based treatment are presented.

These clinical guidelines were developed by the professional association of pediatric specialists «Union of Pediatricians of Russia» and approved by the Association’s Executive Committee at the Congress of Pediatricians of Russia «Actual Problems of Pediatrics». Clinical guidelines are devoted to the problem of rotavirus infection, the relevance of which is determined by the high prevalence level and significant contribution of infectious diarrhea to the mortality pattern of children in the first 5 years of life. We present epidemiological data and detailed information on the infectious agent and pathogenesis of rotavirus infection progression. A detailed picture of clinical manifestations as well as extraintestinal complications is presented. The approach to specific prophylaxis has been reasoned. Practical recommendations for immunization as well as various regimens for administering the vaccine, depending on the age and condition of the patient, are given.

The article reviews the results of scientific researches published over the past few years that confirm the significant socioeconomic burden of rotavirus infection and its significant contribution to the morbidity and mortality of the world’s children’s population. The authors presented evidence of the effectiveness of immunization in the routine schedule of preventive vaccinations of infants in both developed and developing countries. A significant reduction in mortality and admissions due to severe forms of rotavirus gastroenteritis during the first years of introduction of rotavirus vaccination was shown, which marked a positive trend in the development of health care.

Considering the colossal frequency of infectious diseases among children, pediatricians face the task not only to cure the patient but also to do this as soon as possible with an individual approach to each child. One of the main aspects of diagnosis in febrile children is the differentiation of a bacterial infection from viral one in order to assign timely antibiotic therapy to one patient and to prevent excessive assignment to others. In addition, an important point is to identify the category of patients with a severe bacterial infection, which requires the most attention. The article reveals the main points of a differential diagnosis of bacterial and viral infections, considering clinical symptoms and laboratory parameters: the concentration of procalcitonin, C-reactive protein, and leukocytes. The limits of procalcitonin values for various nosological forms and the possibility of their use in terms of the appointment, continuation or replacement of antibacterial therapy in pediatric practice are described.

The article is devoted to acute respiratory viral infections (ARVI) in children. ARVI take one of the leading places in a childhood morbidity structure. The article provides an overview of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» for acute respiratory infections in children. These guidelines summarize the experience of the leading world and domestic specialists, contain scientific and practical data that correspond to the most relevant trends in the management of children with this pathology. The authors present modern information on the etiology, pathogenesis, classification, clinical findings and differential diagnosis of various nosological forms of acute respiratory tract infections in the pediatric population. The general (strategic) principles of drug-free and drug treatment are discussed in detail.

The article presents the detailed key provisions of the clinical recommendations on providing medical care to children with Kawasaki syndrome/illness, developed by the professional association of pediatric specialists — the Union of Pediatricians of Russia. The current data on the prevalence of pathology is presented, the characteristic diagnostic signs of the disease are given that allow to make a diagnosis as soon as possible and immediately appoint a specific treatment. Therapeutic measures carried out in the required volume determine the further prognosis. The comprehensive approach to the management of pediatric patients with this nosology presented in the article will ensure a high level of medical care quality provided to children with Kawasaki syndrome.

The article is devoted to the urgent problem of papillomavirus infection, the extremely high prevalence of which determines the key contribution to the structure of morbidity and mortality from oncological diseases. A chronic persistent course, resulting in benign and malignant tumors in the infection atrium, makes scientists seek new ways of treatment. A specific vaccinal prevention is recognized to be the only reliable protection method today. The article is an updated review of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» in 2016 for a vaccinal prevention of the diseases caused by human papillomavirus, first published on pediatr-russia.ru. The widespread introduction of vaccines against human papillomavirus, which have confirmed the clinical efficacy and safety, can significantly reduce the global burden of diseases associated with papillomavirus infection.

Although the article is a muddled one, it is nothing but a cry from the heart of the pediatrician, who forcing herself fulfills (or tries to fulfill) the Order of the Ministry of Health of the Russian Federation No.1346 dated December 21, 2012. The author raises a number of questions and gives her answers to them. But before analyzing critical comments of the author and her offers, we should dwell on a number of statements on which her conclusions are based.